Combination therapy of BRAF inhibitors for advanced melanoma with BRAF V600 mutation: a systematic review and meta-analysis. (3rd April 2018)

• Record Type: Journal Article
• Authors: Kim, Siin; Kim, Hyung Tae; Suh, Hae Sun
• Is Part Of: Journal of dermatological treatment. Volume 29:Number 3(2018)
• Page Start: 314
• Page End: 321
• Publication Date: 2018-04-03
• Subjects: Melanoma -- proto-oncogene proteins B-raf -- vemurafenib -- systematic review; Skin -- Diseases -- Treatment -- Periodicals; Skin Diseases -- drug therapy -- Periodicals; Skin Diseases -- therapy -- Periodicals; 616.5
• DOI: 10.1080/09546634.2017.1330530
• Languages: English
• ISSNs: 0954-6634

Abstract

Abstract: Background: Although BRAF inhibitors have been used to treat advanced melanoma with BRAF mutation, combination strategies are suggested due to acquired resistance to BRAF inhibitors. Objective: To assess the efficacy of BRAF inhibitor-based combination therapy for the treatment of advanced melanoma with BRAF mutation. Methods: We conducted a systematic review and meta-analysis of studies that compared BRAF inhibitor-based combination therapy with BRAF inhibitor monotherapy. We searched MEDLINE, EMBASE, the Cochrane Library and relevant conference proceedings. The random-effects inverse variance and Mantel–Haenszel methods were used to pool the results. Results: Four randomized controlled trials and one cohort study were identified. A combination therapy with BRAF inhibitors and MEK inhibitors was used in all studies. The combined hazard ratios of overall survival (OS) and progression-free survival (PFS) comparing combination therapy with monotherapy were 0.70 [95% confidence interval (CI) 0.62–0.78] and 0.59 (95% CI 0.55–0.63), respectively. The combined risk ratio of objective response rate (ORR) was 1.30 (95% CI 1.20–1.40), which meant more patients achieved complete/partial responses in combination therapy group than those in the monotherapy group. Conclusions: Combination therapy with BRAF inhibitors and MEK inhibitors significantly improved OS, PFS, and ORR in patients with advanced melanoma with BRAF mutation.